Synopsis: This paper examines patterns of presenting problems among children served in systems of care and their relationship to clinical characteristics and subsequent service experiences. Latent class analysis identified groups of youth with different patterns of presenting problems among 9,031 males and 4,457 females entering services. For males, results indicated five distinct latent classes. For females, results indicated six distinct latent classes. The children's needs were addressed with a variety of services systematically related to presenting problems. Differences in service experience were associated with clinical outcome differences during the first six months of services. Understanding the differences among these presenting problems classes can help providers individualize services to meet the needs of children they serve.